PBM EnvisionRx chooses Gilead hepatitis C drugs for its formulary

Last Updated: 2015-01-26

By Reuters Staff

(Reuters) - Pharmacy benefits manager EnvisionRx said on Monday it reached an agreement to provide its customers with Gilead Sciences Inc's hepatitis C drugs on an exclusive basis, the latest Gilead victory in a market share battle with AbbVie over their new treatments for the virus.

EnvisionRx said Gilead's Sovaldi (sofosbuvir) and its newer two-drug combination pill Harvoni (ledipasvir and sofosbuvir) would be available on its formulary, with other hepatitis C drugs, such as AbbVie's Viekira Pak (ombitasvir/paritaprevir/ritonavir & dasabuvir) allowed only as an exception in some cases.

It was not disclosed how much of a price discount EnvisionRx negotiated from Gilead to secure the agreement.

"The safety and efficacy profile of Gilead's HCV products, coupled with the most competitive pricing in the drug class, have solidified EnvisionRx's choice to place Gilead's products in an exclusive and preferred formulary position," said EnvisionRx President Dawn Sherman in a statement.

Express Scripts Holding, the largest U.S. pharmacy benefits manager (PBM) which had complained about the high cost of Gilead's first to market treatment, fired the first shot in the hepatitis C price war days after the AbbVie rival treatment was approved. It gave Viekira Pak preference on its formulary, excluding Gilead's drugs.

Gilead then locked up formulary exclusivity for Harvoni with CVS Health, the second largest U.S. PBM.

PBMs negotiate drug pricing for employers and health plans. Health insurers have also chosen sides after negotiating their own discount deals following the Express Scripts move.

Aetna, Anthem and Humana chose Gilead drugs as their preferred treatment, while PBM Prime Therapeutics kept both on its list.

Both treatments have demonstrated an ability to cure well over 90% of patients, although Gilead's Harvoni involves fewer drugs than Viekira.

Harvoni, which combines Sovaldi with another drug, has a list price of $94,500 for 12 weeks of treatment. Viekira Pak was listed at about $83,300.

Analysts believe the companies have been providing discounts of up to 30 percent, although the specific negotiated rebates have not been disclosed.

EnvisionRx provides services for Medicare Part D plans as well as government paid or subsidized insurance through Medicaid, CHIP and individual exchange plans.